Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
Vaccine. 2022 Nov 15;40(48):6931-6938. doi: 10.1016/j.vaccine.2022.10.023. Epub 2022 Oct 21.
Influenza increases stillbirth risk, morbidity and mortality in pregnant women. Vaccination protects pregnant women against severe disease and indirectly protects their infants, but coverage among pregnant women remains low worldwide. We aimed to describe knowledge, attitudes, and practices (KAP) regarding seasonal influenza vaccination among postpartum women and prenatal care physicians in Costa Rica.
We conducted cross-sectional KAP surveys to women one to three days after childbirth at Costa Rican Social Security Fund maternity hospitals, and obstetricians and general practitioners who provided prenatal care in 2017. Principal components analysis, multiple imputation, and logistic regression were used to examine associations between influenza vaccination and demographics, prenatal care, and sources of information-separately for postpartum women and physicians. We also held two focus groups of six healthcare workers each to further describe vaccination KAP.
We surveyed 642 postpartum women and 146 physicians in maternity hospitals in five Costa Rican provinces of whom 85.5 % (95 % CI: 82.6 %-88.0 %) and 57.9 % (95 % CI: 49.6 %-65.7 %) were vaccinated for influenza, respectively. Factors associated with influenza vaccination for postpartum women included tetanus vaccination (aOR: 3.62, 95 % CI: 1.89-6.92); received vaccination recommendations from clinicians during prenatal check-ups (aOR: 3.39, 95 % CI: 2.06-5.59); had other children in household vaccinated for influenza (aOR: 2.25, 95 % CI: 1.08-4.68); and secondary/university education (aOR: 0.15-0.31) with no formal education as reference. For postpartum women, reasons for vaccination were perceived benefits for mother and infant, whereas not being offered vaccines was most cited for non-vaccination. Most prenatal care physicians recommended influenza vaccines during prenatal check-ups but believed vaccination causes flu-like symptoms.
Vaccination campaigns and provisions of free vaccines effectively increased knowledge and coverage among women in Costa Rica. To improve access, women should be offered vaccines during prenatal care appointments. Educating healthcare workers about vaccine benefits for themselves and patients is needed to mitigate safety concerns.
流感会增加孕妇的死产风险、发病率和死亡率。接种疫苗可预防孕妇罹患重症疾病，并间接保护其婴儿，但全球范围内孕妇的疫苗接种率仍然较低。本研究旨在描述哥斯达黎加产后妇女和产前护理医生对季节性流感疫苗接种的知识、态度和实践（KAP）。
我们于 2017 年在哥斯达黎加社会保障基金妇产医院对产后 1-3 天的妇女，以及提供产前护理的产科医生和全科医生进行了 KAP 横断面调查。主成分分析、多重插补和逻辑回归用于分别检查流感疫苗接种与人口统计学、产前护理和信息来源之间的关联-针对产后妇女和医生。我们还举行了两次由六名医疗保健工作者参加的焦点小组讨论，以进一步描述疫苗接种的 KAP。
我们调查了哥斯达黎加五个省份的妇产医院的 642 名产后妇女和 146 名医生，其中 85.5%（95%CI：82.6%-88.0%）和 57.9%（95%CI：49.6%-65.7%）分别接种了流感疫苗。与产后妇女流感疫苗接种相关的因素包括破伤风疫苗接种（aOR：3.62，95%CI：1.89-6.92）；在产前检查期间从临床医生那里获得疫苗接种建议（aOR：3.39，95%CI：2.06-5.59）；家中有其他儿童接种流感疫苗（aOR：2.25，95%CI：1.08-4.68）；以及中学/大学教育（aOR：0.15-0.31），无正规教育作为参照。对于产后妇女，接种疫苗的原因是认为对母婴有益，而不接种疫苗的主要原因是未提供疫苗。大多数产前护理医生在产前检查期间建议接种流感疫苗，但他们认为疫苗会引起类似流感的症状。
疫苗接种运动和免费疫苗的提供有效提高了哥斯达黎加妇女的知识水平和疫苗接种率。为了增加疫苗接种的可及性，应该在产前护理期间为妇女提供疫苗。需要教育医疗保健工作者疫苗对他们自己和患者的益处，以减轻对安全性的担忧。
